For more information: https://hpets.org/index.php
I had never even heard of ANNPE before this and wanted to hear some stories of others who have dealt with it. She’s already going pee on her own-just in a weird position since we have to hold her up with the help em up harness. She can hold her back legs straight, seemingly putting a tiny bit of weight on them, and will try to “walk” with the harness on but her toes tend to bend under a bit. Her neurologist said that she’s had a deep pain sensation this whole time which is good. I know it’s super early in her recovery process, but the past few days have been so stressful, sad, and exhausting so it would be great to hear some stories and advice from others.
In the study quoted below, 99% of ANNPE dogs regained the ability to walk, and in 83.6% you could still tell there must have been a past injury by the way they walked. It says it is possible there will be bowel incontinence, but over 75% of dogs did not even have that.
Dogs don't care if they are walking like a show dog or not. They don't care how it looks, they just care that they get where they are going.
If your dog is urinating on her own, that is super encouraging. I assume she is a large breed if you are using the Help em up harness. If you have any questions about caring for a large down dog, please don't hesitate to ask.https://veterinaryrecord.bmj.com/content/181/11/293 wrote:Abstract
Presumptive ANNPE and FCEM were diagnosed in 157 and 44 dogs , respectively. Ambulatory function was regained in 99 per cent of cases, with persistent motor deficits in 83.6 per cent and 92.5 per cent of dogs with presumptive ANNPE and FCEM, respectively. The presumptive diagnosis was not associated with motor function recovery, recovery times or urinary continence. Faecal incontinence was five times more likely in dogs with presumptive ANNPE (23 per cent) compared with presumptive FCEM (7.5 per cent).
I don't know if the vet discussed doing physical therapy with you. especially hydrotherapy. PT can be done professionally or at home. I imagine you've already spent quite a bit on the MRI, but if you can afford it, getting some appointments at a rehab place that has either a swimming pool or an underwater treadmill is worth the money. There is a reflex in dogs where if they move their front legs it fires signals to the hind legs, which can happen either swimming or on an underwater treadmill. The benefit of the water is, it supports the dog while the dog cannot bear weight yet. It is an effort to get a large dog in and out of the car for appointments, but if you can handle it (physically, financially, and time-wise) it would likely help. The physical therapist will probably also give you a list of exercises to do at home, which is very helpful.
People have also rehabbed dogs themselves in swimming pools, lakes, and spas when the weather is warm enough. If you are using a swimming pool, you may need 2 people in order to get a very large dog back out. Having either a harness or a flotation vest with a handle on the top gives you something to grab to lift the dog out.
It is fantastic that she is trying to take little steps with her hind feed. When the toes turn under it is called 'knuckling'. That is totally normal and will probably continue for a while until she learns to place her feet again. Some dogs will scrape the tops of their feet during recovery, but you get through it. Some people protect the feet with dog boots, some people just nurse the scrapes. There are special lightweight dog boots that will help her keep her toes in the right position (not turned under). Let me know if you want links or pictures.
As far as PT, the vet sent us home with things we can do ourselves. I was thinking of looking into hydrotherapy as well, but I’m not sure how well she’d do with that since water kind of freaks her out.
The links for feet protection also really help out, I’ll definitely check those out. I’m really hopeful for her recovery, she already seems to be making baby steps and it’s only been a day. I’m a little worried for when I have to go back to work, but I can come home throughout the day to check on her. We also got a crate for her but I found it’s pretty difficult to move her in and out of that, so I think we’ll try a playpen instead so she’s not trying to move too much if we’re not here. I have a camera that I can watch her on as well. I’m sure she’ll be fine when we work, but of course I’m just worried about leaving her alone at this point. She’s been with me throughout all my years of college and a lot of hard times, she’s taken care of me all this time and now it’s her turn. Thanks again!
I agree, it's really awkward and probably not safe for the caregiver's back to be getting a 60-lb dog into and out of a wire crate. It's not a great idea to be bending over and trying to support the weight in through the doorway of a crate. It's risking a back strain. The playpen idea will be much easier. I assume you mean a playpen such as an exercise pen, like in these pictures:
I'm not sure about the water, either. My experience is, they introduce your dog to it gradually, which means the first few sessions the dog will not be getting as much actual swimming or walking on the treadmill, but they will get some other exercises during those sessions, too. It's worth it to build up gradually so the dog gets used to the idea and can then do PT. With my dog, her first session in the treadmill was 5 minutes, the second session 10, the third 15, and so on. My dog didn't happen to like being in the water at first, but she came to love it. I would think, if you want to try the hydrotherapy, maybe let the therapist determine whether the dog is totally against water, or if she will adapt with time and treats.
Some of the boots that keep the toes from knuckling have to be ordered through a vet or therapist, I don't know about all of them. I guess they want to be sure they are being used for the right medical conditions under veterinary supervision, but that's fine. I think they are sold one boot at a time, not in pairs, so double-check how many you are getting if you decide to order her some.
That is great if you have a puppy cam and can watch her, and really great if you're able to get home during the day if needed. It is hard to leave them both for practical reasons and also because somehow there is a stronger tie between you and your pet at a time like this, which doesn't let you get as far away or turn your attention to other matters for long. During the first days/weeks it seems like you spend most of your time thinking about your pet, and she's in the back of your mind even when you are busy with something else. Your mind is trying to figure out all the details of the situation, and the best way to do everything. The first weeks are the most stressful, but after a while you have a good routine and it gets easier.
I'm glad they gave you exercises to do. If she's already moving her back legs pretty well, that sounds very encouraging. Seeing even little improvements is what keeps you going!
I wanted to keep her progress updated here because when I first found out she had ANNPE I felt like I had a hard time finding people with dogs who had been through this. This forum had the most personal stories I could find and that really gave me peace of mind. I feel a lot more hopeful today!
I'm very glad she is recovering so quickly. She stood up, can squat, is managing the stairs, and fixing her feet. Woohoo!!! It sounds really good!
One thing to keep in mind with spinal injuries is, recovery continues for a l-o-n-g time. You are seeing a lot of improvement right now, but if by chance you still notice some deficits in the coming weeks or months, just remember the nerves can continue to heal and she can improve...for years.
Part of the issue with not finding a lot of stories about dogs who had ANNPE is that it's a relatively new diagnosis. From what I can tell (not being a vet or anything medical) they used to diagnose IVDD and FCE. IVDD was divided between 2 types of disk problems (Hansen I and Hansen II). They recognized there was another type of disk injury (a high velocity low volume disk extrusion) that had some similarities to both disk disease and FCE. Some sources called it Hansen III, but eventually they began calling it ANNPE and in the past decade you're hearing it more.
Very glad to hear so much progress so fast! It sounds like she's doing super well!
This morning she actually stood and walked a bit by herself, wobbly of course but she still did it! She seems to be doing very well holding her own weight, her balance is just off still. Of course I’m happy she’s improving so quickly, but we’re also prepared for a long road ahead. Before this she was walking almost 5 miles a day with us and would run around for an hour at the park with her ball-we’re definitely not expecting that same dog back any time soon, and that’s okay! She’s tolerating all of her at home physical therapy really well, and I’m planning on looking into hydrotherapy for her today.
If you get her into professional PT, they will probably work on her balance as part of the program. They have special equipment they can use. Here are some examples of canine PT. If you watch the videos on this page I don't think you have to watch any ads.
https://www.calanimalrehab.com/therapeu ... rcises.htm
It shows a large peanut ball/balance ball, or a rocker board. Further down the page is a very short video of a balance board/wobble board. I do not know if they will do these exercises, but they will know what is appropriate.
One balance exercise you might be able to do at home without equipment is weight shifting. With your dog in a standing position, you simply press on her hip to sway her to one side an inch or two, then press on her other hip to sway her to the other side. It makes them bear more weight on each leg in turn. You might want to ask the therapist/vet if this is appropriate for your dog, and how many reps.
She’s still doing well, her walking seems to improve a tiny bit each day. I talked to her neurologist and he recommended setting up a meeting with their rehab team to change some of her physical therapy now that she’s walking-to help with balance and such. He said she should still lay low for the most part and recommended 5 minute walks for now, and building up by 5 minutes each week. She seems pretty content with that since she’s tiring out pretty easily these days. I’m sure it’s hard work basically learning to use those legs again!